scholarly journals Preconception Dietary Folate Intake and Risk of Spontaneous Abortion

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 771-771
Author(s):  
Anne Sofie Laursen ◽  
Elizabeth E Hatch ◽  
Lauren A Wise ◽  
Kenneth J Rothman ◽  
Henrik T Sørensen ◽  
...  
Keyword(s):  
Folic Acid ◽  
Alcohol Intake ◽  
Fetal Loss ◽  
Study Entry ◽  
Folate Intake ◽  
Folic Acid Supplement ◽  
Dietary Folate ◽  
Supplement Use ◽  
Acid Supplement ◽  
Dietary Folate Intake

Abstract Objectives Previous studies suggest a beneficial effect of supplemental folic acid use and dietary folate intake on fertility, while results for fetal loss are conflicting. Most previous research on fetal loss focused on folic acid supplement use. We therefore, investigated the association between dietary folate intake and spontaneous abortion (SAB) in a Danish preconception cohort of couples trying to conceive. Methods We recruited couples who were trying to conceive and did not receive fertility treatment. Pregnancies were ascertained through bimonthly follow-up questionnaires completed up to 12 months after study entry. SABs were identified by self-report on the follow-up questionnaires and through the Danish National Patient Registry. Dietary folate intake at study entry was estimated using a validated food frequency questionnaire (FFQ). Folate intake was adjusted for total energy intake using the residual method and categorized as < 250,250–399 and > = 400µg/day. We used Cox proportional hazards regression models with gestational weeks as time scale to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for SAB, adjusting for age, partner's age, educational attainment, smoking status, anthropometry, physical activity, alcohol intake, folic acid supplement use, time-to-pregnancy, gravidity and parity. In sensitivity analyses, we stratified by folic acid supplement use, body mass index (BMI) and alcohol intake. Results Of the 2,957 women who became pregnant within 12 months of study entry and completed the FFQ, we identified 432 SABs. HRs for an SAB among women who consumed 250–399 and >= 400 µg/day of dietary folate compared with <250 µg/day were 0.83 (95% CI: 0.53; 1.29) and 0.87 (95% CI: 0.54; 1.39), respectively. Comparing intake > = 400 with <250 µg/day, the association was stronger when the analysis was restricted to folic acid supplement users, 0.74 (95% CI: 0.39; 1.40), to women with a BMI >= 25, 0.67 (95% CI: 0.31; 1.43), and to a reported alcohol intake >4 drinks/week, 0.66 (95% CI: 0.16; 2.66). Conclusions Our study may suggest that high dietary folate intake among folic acid supplement users is associated with a lower risk of SAB, although our estimates are imprecise. Funding Sources National Institute of Child Health and Human Development.

scholarly journals Dietary Folate Intake and Folic Acid Supplements among Pregnant Women from Southern Italy: Evidence from the “Mamma & Bambino” Cohort

2020 ◽  
Vol 17 (2) ◽  
pp. 638 ◽  
Author(s):  
Martina Barchitta ◽  
Andrea Maugeri ◽  
Roberta Magnano San Lio ◽  
Giuliana Favara ◽  
Claudia La Mastra ◽  
...  
Keyword(s):  
Folic Acid ◽  
Pregnant Women ◽  
Neonatal Outcomes ◽  
Folate Intake ◽  
Folic Acid Supplement ◽  
Dietary Folate ◽  
Supplement Use ◽  
Acid Supplement ◽  
Folic Acid Supplements ◽  
Dietary Folate Intake

Folate requirement among women who plan to become pregnant should be raised to 600 μg/day during the periconceptional period. To meet this need, several countries began to promote the use of folic acid supplements before and during pregnancy. Here, we investigated prevalence and determinants of dietary folate intake and folic acid supplement use among 397 pregnant women (aged 15–50 years old, median = 37 years old). We also investigated their effects on neonatal outcomes in a subgroup of women who completed pregnancy. For doing that, we used data from the “Mamma & Bambino” project, an ongoing mother-child cohort settled in Catania (Italy). Inadequate folate intake was evaluated using a Food Frequency Questionnaire and defined as an intake < 600 μg/day. Women were also classified as non-users (i.e., women who did not use folic acid supplements), insufficient users (i.e., women who did not take folic acid supplements as recommended), and recommended users of folic acid supplements. Neonatal outcomes of interest were preterm birth (PTB) and small for gestational age (SGA). Nearly 65% of women (n = 257) reported inadequate folate intake, while 74.8% and 22.4% were respectively classified as insufficient or recommended users of supplements. We demonstrated higher odds of inadequate folate intake among smoking women (OR = 1.457; 95%CI = 1.046–2.030; p = 0.026), those who followed dietary restrictions (OR = 2.180; 95%CI = 1.085–4.378; p = 0.029), and those with low adherence to the Mediterranean Diet (OR = 3.194; 95%CI = 1.958–5.210; p < 0.001). In a subsample of 282 women who completed pregnancy, we also noted a higher percentage of SGA among those with inadequate folate intake (p < 0.001). Among 257 women with inadequate folate intake, those with low educational level were more likely to not take folic acid supplements than their more educated counterpart (OR = 5.574; 95%CI = 1.487–21.435; p = 0.012). In a subsample of 184 women with inadequate folate intake and complete pregnancy, we observed a higher proportion of SGA newborns among women who did not take supplement before pregnancy and those who did not take at all (p = 0.009). We also noted that the proportion of PTB was higher among non-users and insufficient users of folic acid supplements, but difference was not statistically significant. Our study underlined the need for improving the adherence of pregnant women with recommendations for dietary folate intake and supplement use. Although we proposed a protective effect of folic acid supplement use on risk of SGA, further research is encouraged to corroborate our findings and to investigate other factors involved.

scholarly journals Epidemiology and (Patho)Physiology of Folic Acid Supplement Use in Obese Women before and during Pregnancy

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 331
Author(s):  
Melissa van der Windt ◽  
Sam Schoenmakers ◽  
Bas van Rijn ◽  
Sander Galjaard ◽  
Régine Steegers-Theunissen ◽  
...  
Keyword(s):  
Folic Acid ◽  
Scientific Evidence ◽  
Folate Deficiency ◽  
Folate Intake ◽  
Low Grade ◽  
Obese Women ◽  
Folic Acid Supplement ◽  
Physiological Uptake ◽  
Supplement Use ◽  
Acid Supplement

Preconception folic acid supplement use is a well-known method of primary prevention of neural tube defects (NTDs). Obese women are at a higher risk for having a child with a NTD. As different international recommendations on folic acid supplement use for obese women before and during pregnancy exist, this narrative review provides an overview of epidemiology of folate deficiency in obese (pre)pregnant women, elaborates on potential mechanisms underlying folate deficiency, and discusses considerations for the usage of higher doses of folic acid supplements. Women with obesity more often suffer from an absolute folate deficiency, as they are less compliant to periconceptional folic acid supplement use recommendations. In addition, their dietary folate intake is limited due to an unbalanced diet (relative malnutrition). The association of obesity and NTDs also seems to be independent of folate intake, with studies suggesting an increased need of folate (relative deficiency) due to derangements involved in other pathways. The relative folate deficiency, as a result of an increased metabolic need for folate in obese women, can be due to: (1) low-grade chronic inflammation (2) insulin resistance, (3) inositol, and (4) dysbiotic gut microbiome, which plays a role in folate production and uptake. In all these pathways, the folate-dependent one-carbon metabolism is involved. In conclusion, scientific evidence of the involvement of several folate-related pathways implies to increase the recommended folic acid supplementation in obese women. However, the physiological uptake of synthetic folic acid is limited and side-effects of unmetabolized folic acid in mothers and offspring, in particular variations in epigenetic (re)programming with long-term health effects, cannot be excluded. Therefore, we emphasize on the urgent need for further research and preconception personalized counseling on folate status, lifestyle, and medical conditions.

scholarly journals Maternal Folic Acid Supplementation, Dietary Folate Intake and Low Birth Weight: A Birth Cohort Study

2021 ◽  
Author(s):  
LiPing Yang ◽  
Wenjuan Wang ◽  
Baohong Mao ◽  
Jie Qiu ◽  
Huaqi Guo ◽  
...  
Keyword(s):  
Folic Acid ◽  
Folic Acid Supplementation ◽  
Folate Intake ◽  
Care Hospital ◽  
Folic Acid Supplement ◽  
Dietary Folate ◽  
Acid Supplementation ◽  
Dietary Folate Intake ◽  
Reduced Risk ◽  
Joint Associations

Abstract ObjectivesTo investigate the independent and collective effects of maternal folic acid supplementation or dietary folate intake upon the risk of low birth weight (LBW), and to further comprehensively examine the joint associations of folic acid supplementation and dietary folate intake with LBW by various clinical subtypes.DesignParticipants were recruited in Gansu Provincial Maternity and Child Care Hospital. A standardized and structured questionnaire was distributed to collect demographic factors, reproductive and medical history, occupational and residential history, physical activity and diet. Data on pregnancy-related complications and birth outcomes were extracted from medical records. Unconditional logistic regression models were used to estimate odds ratio (OR) and 95% confidence interval (95%CI) for single and joint associations of folic acid supplementation and dietary folate intake with LBW. SettingA birth cohort data analysis using the 2010–2012 Gansu Provincial Maternity and Child Care Hospital in Lanzhou, China.Participants9231 pregnant women and their children were enrolled in the study. ResultsCompared to non-users, folic acid supplementation was associated with a reduced risk of LBW (OR: 0.80, 95%CI: 0.66-0.97), and the reduced risk was mainly seen for term-LBW (OR: 0.59, 95%CI: 0.41-0.85), and multiparous-LBW (OR: 0.72, 95%CI: 0.54-0.94). For dietary folate intake, there were no significant associations with LBW, and there was no interaction of folic acid supplement and dietary folate intake on LBW.ConclusionsOur study results indicated that folic acid supplementation was associated with a reduced risk of LBW, and there was not interaction of folic acid supplement and dietary folate intake on LBW.

scholarly journals Folic acid food fortification prevents inadequate folate intake among preschoolers from Ontario

2009 ◽  
Vol 12 (9) ◽  
pp. 1548-1555 ◽  
Author(s):  
Kathleen Hennessy-Priest ◽  
Jill Mustard ◽  
Heather Keller ◽  
Lee Rysdale ◽  
Joanne Beyers ◽  
...  
Keyword(s):  
Folic Acid ◽  
Public Health Intervention ◽  
Folate Intake ◽  
Food Fortification ◽  
Folic Acid Intake ◽  
Cross Sectional ◽  
Dietary Folate ◽  
Supplement Use ◽  
Acid Intake ◽  
Fortified Food

AbstractObjectiveFolic acid food fortification has successfully reduced neural tube defect-affected pregnancies across Canada. The effect of this uncontrolled public health intervention on folate intake among Canadian children is, however, unknown. Our objectives were to determine folic acid intake from food fortification and whether fortification promoted adequate folate intakes, and to describe folic acid-fortified food usage among Ontario preschoolers.DesignCross-sectional data were used from the NutriSTEP™ validation project with preschoolers recruited using convenience sampling. Mean daily total folate and folic acid intakes were estimated from 3 d food records, which included multivitamin supplement use. Comparisons were made to Dietary Reference Intakes, accounting for and excluding fortificant folic acid, to determine the prevalence of inadequate and excessive intakes.SettingCanada.SubjectsTwo hundred and fifty-four preschoolers (aged 3–5 years).ResultsAll participants (130 girls, 124 boys) ate folic acid-fortified foods and 30 % (n76) used folic acid-containing supplements. Mean (se) fortificant folic acid intake was 83 (2) μg/d, which contributed 30 % and 50 % to total folate intake for supplement users and non-users, respectively. The prevalence of total folate intakes below the Estimated Average Requirement was <1 %; however, excluding fortificant folic acid, the prevalence was 32 %, 54 % and 47 % for 3-, 4- and 5-year-olds, respectively. The overall prevalence of folic acid (fortificant and supplemental) intakes above the Tolerable Upper Intake Level was 2 % (7 % among supplement users).ConclusionsFolic acid food fortification promotes dietary folate adequacy and did not appear to result in excessive folic acid intake unless folic acid-containing supplements were consumed.

scholarly journals Patterns and predictors of folic acid supplement use among pregnant women: the Norwegian Mother and Child Cohort Study

2006 ◽  
Vol 84 (5) ◽  
pp. 1134-1141 ◽  
Author(s):  
Roy M Nilsen ◽  
Stein E Vollset ◽  
Håkon K Gjessing ◽  
Per Magnus ◽  
Helle M Meltzer ◽  
...  
Keyword(s):  
Cohort Study ◽  
Folic Acid ◽  
Pregnant Women ◽  
Folic Acid Supplement ◽  
Supplement Use ◽  
Acid Supplement ◽  
Mother And Child

Folic acid supplementation, dietary folate intake and risk of small for gestational age in China

2019 ◽  
Vol 23 (11) ◽  
pp. 1965-1973
Author(s):  
Huaqi Guo ◽  
Baohong Mao ◽  
Meng Wang ◽  
Qing Liu ◽  
Liping Yang ◽  
...  
Keyword(s):  
Folic Acid ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Folic Acid Supplementation ◽  
Folate Intake ◽  
Care Hospital ◽  
Dietary Folate ◽  
Acid Supplementation ◽  
Dietary Folate Intake ◽  
Reduced Risk

AbstractObjective:To investigate the hypothesis that folic acid supplementation and dietary folate intake before conception and during pregnancy reduce the risk of small for gestational age (SGA) and to examine the joint effect of folic acid supplementation and dietary folate intake on the risk of SGA.Design:Participants were interviewed by trained study interviewers using a standardized and structured questionnaire. Information on birth outcomes and maternal complications was abstracted from medical records and dietary information was collected via a semi-quantitative FFQ before conception and during pregnancy.Setting:A birth cohort data analysis using the 2010–2012 Gansu Provincial Maternity and Child Care Hospital.Participants:Women (n 8758) and their children enrolled in the study.Results:Folic acid supplementation was associated with a reduced risk of SGA (OR = 0·72, 95 % CI 0·60, 0·86), with the reduced risk seen mainly for SGA at ≥37 weeks of gestational age (OR = 0·70, 95 % CI 0·58, 0·85) and nulliparous SGA (OR = 0·67, 95 % CI 0·54, 0·84). There was no significant association between dietary folate intake and SGA risk.Conclusions:Our study suggested that folic acid supplementation was associated with a reduced risk of SGA and the risk varied by preterm status and parity.

scholarly journals Comparison of standardised dietary folate intake across ten countries participating in the European Prospective Investigation into Cancer and Nutrition

2011 ◽  
Vol 108 (3) ◽  
pp. 552-569 ◽  
Author(s):  
Jin Young Park ◽  
Genevieve Nicolas ◽  
Heinz Freisling ◽  
Carine Biessy ◽  
Augustin Scalbert ◽  
...  
Keyword(s):  
Educational Level ◽  
Food Sources ◽  
Folate Intake ◽  
International Agency ◽  
Cross Sectional ◽  
Dietary Folate ◽  
Supplement Use ◽  
Methylation Of Dna ◽  
Dietary Folate Intake ◽  
Prospective Investigation

Folate plays an important role in the synthesis and methylation of DNA as a cofactor in one-carbon metabolism. Inadequate folate intake has been linked to adverse health events. However, comparable information on dietary folate intake across European countries has never been reported. The objective of the present study was to describe the dietary folate intake and its food sources in ten countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. A cross-sectional analysis was conducted in 36 034 participants (aged 35–74 years) who completed a single 24 h dietary recall using a computerised interview software program, EPIC-Soft® (International Agency for Research on Cancer, Lyon). Dietary folate intake was estimated using the standardised EPIC Nutrient DataBase, adjusted for age, energy intake, weight and height and weighted by season and day of recall. Adjusted mean dietary folate intake in most centres ranged from 250 to 350 μg/d in men and 200 to 300 μg/d in women. Folate intake tended to be lower among current smokers and heavier alcohol drinkers and to increase with educational level, especially in women. Supplement users (any types) were likely to report higher dietary folate intake in most centres. Vegetables, cereals and fruits, nuts and seeds were the main contributors to folate intake. Nonetheless, the type and pattern of consumption of these main food items varied across the centres. These first comparisons of standardised dietary folate intakes across different European populations show moderate regional differences (except the UK health conscious group), and variation by sex, educational level, smoking and alcohol-drinking status, and supplement use.

scholarly journals Changes in dietary folate intake differentially affect oxidised lipid and mitochondrial DNA damage in various brain regions of rats in the absence/presence of intracerebroventricularly injected amyloid β-peptide challenge

2011 ◽  
Vol 105 (9) ◽  
pp. 1294-1302 ◽  
Author(s):  
Ta-Fu Chen ◽  
Ming-Jang Chiu ◽  
Chou-Tz Huang ◽  
Ming-Chi Tang ◽  
Sue-Jane Wang ◽  
...  
Keyword(s):  
Lipid Peroxidation ◽  
Dna Damage ◽  
Folic Acid ◽  
Neuronal Death ◽  
Brain Regions ◽  
Folate Intake ◽  
Amyloid Β Peptide ◽  
Aβ Peptide ◽  
Dietary Folate ◽  
Dietary Folate Intake

Accumulating evidence suggests that changes in dietary folate intake may modulate the risks of Alzheimer's disease (AD) through as yet unknown mechanisms. The aims of the present study were to investigate how dietary folate affects the brain folate distribution, levels of oxidised lipid and DNA damage in the absence/presence of β-amyloid(25–35)(Aβ) peptide challenge, a pathogenic hallmark of AD. Male Wistar rats were assigned to diets with folic acid at 0 (folate deprivation; FD), 8 (moderate folate; MF) and 8 mg folic acid/kg diet+0·003 % in drinking-water (folate supplementation; FS) for 4 weeks. A single injection of Aβ peptide (1 mg/ml) or the vehicle solution was intracerebroventricularly (icv) administrated to rats a week before killing. Brain folate, a marker of oxidative injury, and neuronal death were assayed. In the absence of an Aβ injection, FD rats showed reduced folate levels, and increased 2-thiobarbituric acid-reactive substances and a mitochondrial (mt)DNA 4834 bp large deletion (mtDNA4834deletion) in the hippocampus compared with the counterpart brains of control rats (P < 0·05). A single icv injection of Aβ peptide potentiated lipid peroxidation in the medulla of FD rats, which was ameliorated by feeding FD rats with the MF and FS diets (P < 0·05). Feeding the FS diet to Aβ-injected rats enriched brain folate levels and reduced mtDNA4834deletion in the hippocampal and medullary regions compared with corresponding tissues of Aβ+FD rats (P < 0·05). Aβ+FS rats had reduced rates of neuronal death in the frontal cortex compared with Aβ+FD rats (P < 0·05). Taken together, our data revealed that folate deprivation differentially depleted brain folate levels, and increased lipid peroxidation and mtDNA4834deletions, particularly, in the hippocampus. Upon Aβ challenge, the FS diet may protect various brain regions against lipid peroxidation, mitochondrial genotoxicity and neural death associated with folate deprivation.

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